scholarly journals Cytomegalovirus Infection during Pregnancy and Its Impact on the Intrauterine Fetal Development – Case Report

2016 ◽  
Vol 4 (3) ◽  
pp. 449-452 ◽  
Author(s):  
Mariya Angelova Angelova ◽  
Emil Kovachev ◽  
Nikolai Todorov

AIM: The aim of this publication is to present a case of CMV infection during pregnancy, with clinical manifestations of the development of microcephaly and simultaneous dilatation of the 3rd and 4th brain ventricle at 23 weeks gestation. This article discusses the role of ultrasound screening in the second trimester of pregnancy.CASE PRESENTATION: We present the case of a 25-year-old woman with the initials S.K. in her second pregnancy that came to our antenatal Consulting Centre. The first screening for blood count, blood group, biochemistry and serology showed results within the reference range. The patient came for a second comprehensive biochemical screening at 17 – 18 weeks gestation. The results showed the low genetic risk of congenital anomalies. Fetal morphology of the fetus was normal. S.K. came again for consultation at 22 weeks gestation in connection with the admittance of her first 3-year-old child to the hospital because of pneumonia. Serological tests of the child had shown elevated CMV titer - specific IgM. Then we made new serological tests of the patient and the results have shown that the patient was most likely infected by CMV primarily in the first trimester of pregnancy. After consulting about the risk of transmission of CMV to the fetus, the woman chose monthly ultrasound scans and refused amniocentesis. At 36 weeks gestation, in addition to the microcephaly already established, enlargement of the IV brain ventricle at the expense of underdevelopment of the cerebellum was noticed. Also, 2nd to 3rd stage of placenta maturity and low quantity of amniotic fluid was established. A male fetus of weight 2,890 g and height 50 cm was delivered.   The fetus was with skin petechiae and hepatosplenomegaly. Neurological examination showed no abnormalities.CONCLUSIONS: In the described case the time interval between infection and ultrasonic manifestations is more than 17 weeks. The long interval between infection and occurrence of ultrasound markers can be a good prediction sign, as it may reflect less aggressive viral infection than present in cases where similar ultrasound findings were obtained shortly after infection of the mother.

Author(s):  
Tamara Illescas ◽  
Waldo Sepulveda ◽  
Begona Adiego ◽  
Pilar Martinez-Ten

ABSTRACT In the last 20 years, the role of first-trimester ultrasound screening has expanded from individual calculation of the risk of aneuploidy through measurement of the nuchal translucency to a powerful technique to evaluate important aspects of the fetal anatomy. Traditionally, the full anatomy scan for detection of structural anomalies has been performed in the second trimester of pregnancy. However, with the implementation of the first-trimester scan at 11 to 13 weeks of gestation many of the structural anomalies traditionally detected in the second trimester can now be identified earlier in pregnancy. In the first part of this review we discuss the main ultrasound findings that may facilitate the prenatal detection of fetal brain, face and neck abnormalities in the first trimester of pregnancy. How to cite this article Sepulveda W, Illescas T, Adiego B, Martinez-Ten P. Prenatal Detection of Fetal Anomalies at the 11- to 13-Week Scan—Part I: Brain, Face and Neck. Donald School J Ultrasound Obstet Gynecol 2013;7(4):359-368.


Author(s):  
T. Saravanan ◽  
Hephzibah Kirubamani

Introduction: In the early stages of pregnancy, ultrasound is an extremely specific method for examination. This article reviews how the normal development of a baby in the first trimester of pregnancy relates to ultrasound findings. Aim: To highlight the importance of routine ultrasonography in the first trimester of pregnancy in detecting and dating gestation, its viability and early detection of anomalies and complications Methods: This descriptive study involved 100 pregnant women within 12 weeks of gestation attending antenatal clinic at Saveetha Medical college, during the study period Inclusion Criteria: Pregnant women with history of amenorrhea <12 weeks of gestation. Exclusion criteria: Individuals with history of pain abdomen and bleeding per vaginum Results: A total of 99 pregnancies were intrauterine of which 1 was anembryonic and 2 had early pregnancy failure, 15 pregnancies were redated. One ectopic and one fibroid complicating pregnancy were aslo found. Conclusion: Ultrasonography is an effective method to detect and date pregnancy, identify nonviable pregnancies, fetal abnormalities and early trimester complications. Hence it is ideal to use it routinely as screening tool during the first trimester of pregnancy.


2018 ◽  
Vol 7 (4) ◽  
pp. 467-470
Author(s):  
Wasan Wajdi Ibrahim ◽  
Afraa Mahjoob Al-Naddawi ◽  
Hayder A. Fawzi

Objectives: Assessment of glycodelin (GD) as a marker for unruptured ectopic pregnancy (EP) in the first trimester of pregnancy. Materials and Methods: This case-control study was conducted during June 2016 to May 2017 in the Obstetrics and Gynecological Department of Baghdad University at Baghdad teaching hospital/medical city complex. In this study, 100 pregnant women in their first trimester of pregnancy were included after clinical and ultrasonic findings. Results: Based on the results, GD levels in EP were significantly lower than those with normal intrauterine pregnancy (1.58 ± 1.18 vs. 30.1 ± 11.9). In addition, using receiver operator curve analysis, the cut-off GD level of 9.5 and less had acceptable validity results (100% sensitivity, 100% specificity, 95% positive predictive value, 100% negative predictive value, and accuracy 100%) to predict EP. Conclusions: In general, serum GD is considered as an excellent predictor of unruptured EP.


2021 ◽  
Vol 20 (2) ◽  
Author(s):  
Huub F.J. Savelkoul

Autism spectrum disorders (ASD) is a heterogeneous group of behavioral disorders in which a disturbed immune reactivity can contribute to the etiology. In retrospective research we found an association between the risk to develop ASD and the month of birth with a peak in July pointing at a possible decreased exposure to sunlight during the first two semesters of pregnancy. This could point to an important role of vitamin D which has important anti-inflammatory and anti-oxidant activities and thereby regulates the proper functioning of the immune system in these individuals. Maternal serum levels of vitamin D double during the first trimester of pregnancy and therefore decreased exposure to sunlight resulting in diminished levels of vitamin D production can be an important risk factor for the development of ASD. However, there is a need for more integrated multidisciplinary studies in families where all siblings are also studied to elucidate the contribution of their genetic risk factors.


Vaccines ◽  
2019 ◽  
Vol 7 (3) ◽  
pp. 72 ◽  
Author(s):  
Gustavo Cabral-Miranda ◽  
Stephanie M. Lim ◽  
Mona O. Mohsen ◽  
Ilya V. Pobelov ◽  
Elisa S. Roesti ◽  
...  

Zika virus (ZIKV) is a flavivirus similar to Dengue virus (DENV) in terms of transmission and clinical manifestations, and usually both viruses are found to co-circulate. ZIKV is usually transmitted by mosquitoes bites, but may also be transmitted by blood transfusion, via the maternal–foetal route, and sexually. After 2015, when the most extensive outbreak of ZIKV had occurred in Brazil and subsequently spread throughout the rest of South America, it became evident that ZIKV infection during the first trimester of pregnancy was associated with microcephaly and other neurological complications in newborns. As a result, the development of a vaccine against ZIKV became an urgent goal. A major issue with DENV vaccines, and therefore likely also with ZIKV vaccines, is the induction of antibodies that fail to neutralize the virus properly and cause antibody-dependent enhancement (ADE) of the infection instead. It has previously been shown that antibodies against the third domain of the envelope protein (EDIII) induces optimally neutralizing antibodies with no evidence for ADE for other viral strains. Therefore, we generated a ZIKV vaccine based on the EDIII domain displayed on the immunologically optimized Cucumber mosaic virus (CuMVtt) derived virus-like particles (VLPs) formulated in dioleoyl phosphatidylserine (DOPS) as adjuvant. The vaccine induced high levels of specific IgG after a single injection. The antibodies were able to neutralise ZIKV without enhancing infection by DENV in vitro. Thus, the here described vaccine based on EDIII displayed on VLPs was able to stimulate production of antibodies specifically neutralizing ZIKV without potentially enhancing disease caused by DENV.


2014 ◽  
Vol 44 (S1) ◽  
pp. 150-150
Author(s):  
F. Crovetto ◽  
F. Figueras ◽  
F. Crispi ◽  
S. Triunfo ◽  
M. Pugia ◽  
...  

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